National Study of Physician Organizations and the Management of Chronic Illness II (NSPO2), 2006-2007 (ICPSR 29801)

Principal Investigator(s):
Shortell, Stephen M., University of California-Berkeley. School of Public Health

Summary:

The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) was designed to improve understanding of evidence-based care management processes (CMPs) as they relate to physician organizations (POs), that is, independent practice associations (IPAs) and medical groups. Since the first NSPO survey of physician organizations in 2000-2001 (NSPO1, archived as ICPSR 4455), considerable investments have been made by a number of different sources, including the Robert Wood Johnson Foundation, the California Healthcare Foundation, and The Commonwealth Fund, to bring about improved care for the chronically ill. This survey, the second NSPO survey of IPAs and medical groups (NSPO2), examined the extent to which the investments in quality improvement were translated into action. NSPO2 assessed the status of CMPs and preventive services use as well as their key drivers in 2006-2007 and the extent to which these factors have changed over time. As in the first NSPO survey, NSPO2 focused on the treatment of four chronic diseases: asthma, congestive heart failure (CHF), depression, and diabetes. Topics covered by the survey include practice type, size, age, ownership, and number of locations; clinical information systems; care management and clinical practice; activities of health insurance plans in chronic illness care; performance incentives; preventative care and health promotion; and organizational culture.
This collection has two data files. The first file contains the NSPO2 survey data, while the second contains a crosswalk between the NSPO1 and NSPO2 case identification numbers which can be used to link the data of the POs that responded to both surveys. Altogether, 369 of the 1,104 POs that responded to NSPO1 also responded to NSPO2.

The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) was designed to improve understanding of evidence-based care management processes (CMPs) as they relate to physician organizations (POs), that is, independent practice associations (IPAs) and medical groups. Since the first NSPO survey of physician organizations in 2000-2001 (NSPO1, archived as ICPSR 4455), considerable investments have been made by a number of different sources, including the Robert Wood Johnson Foundation, the California Healthcare Foundation, and The Commonwealth Fund, to bring about improved care for the chronically ill. This survey, the second NSPO survey of IPAs and medical groups (NSPO2), examined the extent to which the investments in quality improvement were translated into action. NSPO2 assessed the status of CMPs and preventive services use as well as their key drivers in 2006-2007 and the extent to which these factors have changed over time. As in the first NSPO survey, NSPO2 focused on the treatment of four chronic diseases: asthma, congestive heart failure (CHF), depression, and diabetes. Topics covered by the survey include practice type, size, age, ownership, and number of locations; clinical information systems; care management and clinical practice; activities of health insurance plans in chronic illness care; performance incentives; preventative care and health promotion; and organizational culture.

This collection has two data files. The first file contains the NSPO2 survey data, while the second contains a crosswalk between the NSPO1 and NSPO2 case identification numbers which can be used to link the data of the POs that responded to both surveys. Altogether, 369 of the 1,104 POs that responded to NSPO1 also responded to NSPO2.

Guidelines for Applying for Restricted Data

Before you begin an application you will need the following information to complete the form

General Requirements:

appointment at research institution; appointment must be under the jurisdiction of the receiving institution

degree requirements (possibly doctorate)

Must be submitted:

project description

IRB approval

approved security plan

roster of research and IT staff who can access or view the data or computer where data are hosted.

confidentiality pledges for all people on roster

Some require:

CV's

The data files are restricted from general dissemination for reasons of confidentiality. Users interested in obtaining these data must complete an Agreement for the Use of Confidential Data, specify the reasons for the request, and obtain IRB approval or notice of exemption for their research. Apply for access to these data through the ICPSR restricted data contract portal, which can be accessed via the study home page.

Any public-use data files in this collection are available for access by the general public.
Access does not require affiliation with an ICPSR member institution.

Study Description

Citation

Shortell, Stephen M. National Study of Physician Organizations and the Management of Chronic Illness II (NSPO2), 2006-2007. ICPSR29801-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2011-06-14. https://doi.org/10.3886/ICPSR29801.v1

Universe:
All medical groups and IPAs with 20 or more physicians, except those who typically do not see patients with at least one of the chronic diseases of interest: asthma, CHF, depression, or diabetes.

NSPO2 also asked questions to evaluate the California Pay for Performance initiative. However, the responses to these California-specific questions are not included in this data collection.

The data files and SPSS setups use the Windows-1252 character encoding.

Methodology

Study Purpose:
The specific goals of NSPO2 were to: (1) Assess the degree to which use of CMPs and preventive services at large physician organizations has increased and update the measurement of the key factors associated with use of CMPs and preventive care (e.g., market and regulatory incentives, IT capabilities) and the relationships among incentives, IT, and care management; (2) Continue to explore cost-effective approaches to obtain information on CMPs, preventive services, and their drivers in smaller physician practices; (3) Assess the reliability and validity of the CMP measurements; (4) Assess the extent to which a physician organization's CMP usage is perceived by that organization to be replaced by, supplemented by, and/or encouraged either by an IPA or a physician-hospital organization (PHO) that it may belong to or by health insurance plan efforts, including disease management programs; (5) Assess the degree to which incentives for quality improvement, both internal and external, have increased; (6) Examine more in-depth the measurement and public reporting of quality at both the individual and group level; (7) Assess the degree to which the level of information technology capacity has increased, and examine the factors associated with IT use; (8) Assess the culture and patient-focused orientation of the physician organization; (9) Assess awareness and use of some specific programs and initiatives, including the ICIC model, traditional and "virtual" quality collaboratives, rapid cycle quality improvement techniques, "open access" appointments for primary care, and recertification of primary care physicians based on their involvement in quality improvement; (10) Lay the groundwork for future work that examines the relationship between CMP use and patient outcomes; (11) Finally, communicate the findings rapidly and effectively to a variety of key audiences (e.g., the funding organizations, other programs and grantees of the funders, participating organizations, other organizations pursuing quality improvement in healthcare) using a variety of mechanisms (e.g., peer reviewed publications, chart books, newsletters, web sites, conferences).

Sample:
The NSPO team compiled a list of all United States medical groups and IPAs building on prior work for NSPO1 and using information from the Medical Group Management Association, Cattaneo and Stroud Inc., Dorland Healthcare Information, and the Integrated Healthcare Association. POs were excluded if they did not treat any of the four chronic illnesses of interest to the study. Between March 2006 and March 2007, the team attempted to contact each organization in the list, which comprised 1,520 POs, in order to conduct a 35-minute telephone survey with the medical director, president, or chief administrator. Participants were offered $150 for their time. Of the 1,520 POs originally identified, 538 completed the interview, 144 refused to participate, 480 were identified as ineligible to participate because they were no longer in business or did not meet study criteria, and the status of 358 could not be determined despite exhaustive searching.

Mode of Data Collection:
computer-assisted telephone interview (CATI)

Response Rates:
60.3 percent

Extent of Processing: ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of
disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major
statistical software formats as well as standard codebooks to accompany the data. In addition to
these procedures, ICPSR performed the following processing steps for this data collection: